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General NPI Number Information
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NPI Number | 1376643650
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Entity Type | Individual
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Provider Name | MARTHA ELLEN ZUEHLKE MD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 645 N MICHIGAN AVE SUITE 820
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City | CHICAGO
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State | IL
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Zip | 60611-2826
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Country | US
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Telephone | 312-988-7880
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Fax | 708-386-8363
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Provider Business Mailing Address
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Address Line | 842 FAIR OAKS AVE
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City | OAK PARK
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State | IL
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Zip | 60302-1547
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Country | US
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Telephone | 312-988-7880
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Fax | 708-386-8363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036056657
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 036056657
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License Number State | IL
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